BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EZ ACCESS TRIFOLD RAMP ADVANTAGE SERIES, 10 FT, 800# CAPACITY

    MDR report key: 2241004 · Received May 1, 2011

    Report

    Report Number
    MW5022146
    Event Type
    Injury
    Date Received
    May 1, 2011
    Date of Event
    April 30, 2011
    Report Date
    May 1, 2011
    Manufacturer
    EXPRESS RAMPS
    Product Code
    KNO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    QUADRIPLEGIC IN POWER WHEELCHAIR USED A 10 FT TRIFOLD ADVANTAGE-TRIFOLD10AS PORTABLE ACCESS RAMP AND DROVE THE WHEELCHAIR OVER THE SIDE OF THE RAMP. THE LIP FOR GUIDANCE ISN'T STRONG/TALL ENOUGH FOR POWER WHEELCHAIR. SINCE QUADRIPLEGIC, USES CHIN FOR STEERING. FELL ONCE FOOT TO GROUND WITH A (B)(6) WHEELCHAIR. REQUIRED A VISIT TO EMERGENCY ROOM AND SHOULDER X-RAY SHOWING CHIP IN LEFT SHOULDER. THE RAMP HAS A 800# CAPACITY AND LOOKS BENT. DATES OF USE: (B)(6) 2010 - (B)(6) 2011.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EZ ACCESS TRIFOLD RAMP ADVANTAGE SERIES, 10 FT, 800# CAPACITY PORTABLE RAMP KNO EXPRESS RAMPS 100 FOOT TRIFOLD

    Patients

    Seq Age Sex Outcome Treatment
    1 17 YR Hospitalization